Parathyroid adenoma presenting as genu valgum in a child: A rare case report

K. Sreedhar Rao,Praveen Agarwal,Jayachandra Reddy

doi:10.1016/j.ijscr.2019.03.063

K. Sreedhar Rao, Praveen Agarwal + Show 1 more

Open Access

https://doi.org/10.1016/j.ijscr.2019.03.063

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Abstract

IntroductionParathyroid adenoma is the most common cause of primary hyperparathyroidism (PHPT). Patients typically present with elevated serum calcium levels and elevated serum parathyroid hormone levels. The incidence and prevalence is higher in adults but is rare in pediatric age group. Case presentationA 12-year-old, pre-pubertal female presented with pain in bilateral knee joints and gait abnormality since one year. Her past medical history and family history were insignificant. On general examination, no other congenital bony deformities were observed besides genu valgum. Laboratory tests showed hypocalcemia and elevated serum levels of intact parathyroid hormone. Radiograph of bilateral both knee joints was suggestive of genu valgum. Ultra sonogram of neck revealed enlarged parathyroid gland and a Technetium (99mTc) sestamibi scan was suggestive of right inferior parathyroid adenoma. Surgical resection was performed and post-operative hypocalcemia was seen. After necessary treatment was given and the patient was discharged when asymptomatic. Discussion and conclusionParathyroid adenoma causing primary hyperparathyroidism is a rare disease in children. They typically present with nonspecific symptoms involving gastrointestinal, musculoskeletal, renal and neurological symptoms due to hypercalcemia. Moreover, Genu valgum is a rare presentation in children with parathyroid adenoma.

Highlights

Parathyroid adenoma is the most common cause of primary hyperparathyroidism (PHPT)
We present a rare case of parathyroid adenoma with PHPT presenting as Genu valgum, which was diagnosed and treated, at our hospital and this work has been reported in line with the SCARE criteria [5]
Parathyroid adenoma causing primary hyperparathyroidism is a rare disease in children

Summary

INTRODUCTION

Parathyroid adenoma is the most common cause of primary hyperparathyroidism (PHPT). Patients typically present with elevated serum calcium levels and elevated serum parathyroid hormone levels. CASE PRESENTATION: A 12-year-old, pre-pubertal female presented with pain in bilateral knee joints and gait abnormality since one year. Her past medical history and family history were insignificant. Laboratory tests showed hypocalcemia and elevated serum levels of intact parathyroid hormone. Radiograph of bilateral both knee joints was suggestive of genu valgum. DISCUSSION AND CONCLUSION: Parathyroid adenoma causing primary hyperparathyroidism is a rare disease in children. They typically present with nonspecific symptoms involving gastrointestinal, musculoskeletal, renal and neurological symptoms due to hypercalcemia. Genu valgum is a rare presentation in children with parathyroid adenoma

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